Trends in Head CT Use in US Emergency Department Patients From 2007 to 2022

作者：Layne Dylla, Neeharika Krothapalli, Long Tu, Seyedmehdi Payabvash, James Burke, Kevin N. Sheth, Charles Wira, Adam de Havenon · 发表于：Neurology · 年份：2025 · DOI：10.1212/wnl.0000000000214347 · 被引用次数：6 · 研究领域：Radiation Dose and Imaging、Traumatic Brain Injury and Neurovascular Disturbances、Radiology practices and education

BACKGROUND AND OBJECTIVES: Head CT is an essential element of emergency department (ED) diagnosis and treatment of numerous neurologic emergencies. However, it is costly in aggregate, exposes patients to ionizing radiation, and can contribute to increased ED delays and length of stay. The objective of this study was to characterize head CT use in a nationwide sample of EDs between 2007 and 2022. METHODS: This is a retrospective cohort analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS) database from 2007 to 2022. We used multivariable logistic regression to determine the odds of an ED encounter receiving a CT scan of the head, applying NHAMCS survey weights. Study exposures included year, patient demographics, and hospital characteristics. To explore differential trends over time, we created interaction terms between year and patient age, sex, and race/ethnicity. RESULTS: < 0.001). Patients aged 65 years or older had 6.24 (95% CI 5.66-6.88) times the odds of receiving a head CT compared with patients aged younger than 18 years after controlling for year, month, and chief concern at ED admission. Patients who were Black (OR 0.90, 95% CI 0.85-0.96), on Medicaid (OR 0.82, 95% CI 0.77-0.87), or from a rural hospital (OR 0.76, 95% CI 0.70-0.83) were less likely to receive a head CT. DISCUSSION: The overall number of head CT scans during an ED encounter increased more than twofold from 7.8 to 16 million during 2007-2022. Racial, insurance, and geographic varia...